New Year, New Look

It began around a month ago: a growing, but frustratingly nebulous feeling of 'wrongness', accompanied by an appetite for afternoon naps that increased in length. I remembered my wife's warning - "Don't you dare be ill at Christmas!" - and tried to carry on as normal, quietly ducking out of as many social engagements as possible.

I read a lot, including the new Paul Theroux, a mammoth Trollope novel and the wonderful 'Stoner'.

During a drive to see some friends in Hampton, just before Christmas, I wondered how I was going to get through the day and resolved to see a doctor as soon as possible. But what would I tell them? There is an undefined territory between wellness and illness that I've never been able to map. I procrastinated.

Christmas and the New Year were the quietest we'd had for years, so I was able to conceal my growing inability to cope with everyday tasks. I largely kept my worries about the possible causes to myself and resolved to have a full medical as soon as possible.

But three days ago, everything changed. A growing pain in the centre of my stomach quickly became excrutiating as it migrated to the right side. I consulted Google and felt fairly certain that I had appendicitis, but was a trip to hospital justified? I wasn't sure.

I had a vision of a James Robertson Justice-style doctor pressing down on my stomach and annoucing to his young cohorts "Ladies and gentleman, this man has been admitted with suspected appendicitis. I will now demonstrate that it is just wind."

Then I read an entry about the complications that follow a burst appendix and my mind was made up.

The Accident and Emergency department of Brighton Hospital was surprisingly empty for a Saturday night. The only people waiting to be seen were a young couple in their 20s, a rather malodorous homeless man and three Chinese people, who kept changing their seats every five minutes, possibly in an attempt to fox the queueing system.

After what seemed ages, but was probably only 20 minutes, I was assessed and moved to a holding centre, where people lay on beds in cubicles. Opposite me lay a well-spoken woman, who faintly resembled the 122-year-old Jeanne Calment. She appeared to have forgotten what was wrong with her and the nurses' attempts to coax information out of her were largely unsuccessful.

On my left, a curtain concealed a woman who sounded as if she was in her 50s. Unlike Madame Calment, she was able to remember every detail of the last 24 hours and proceed to give a blow-by-blow account of the minutiae of her day: "Then I went to me mum and dad's and I sat down on the sofa, put on the telly and I 'ad a sausage roll..." and on she went, until she eventually proved that ad nausea wasn't just a figure of speech.

When the woman mentioned sausage rolls for the second time, I started to get the giggles. Each movement of laughter produced a spasm of intense pain, so I turned my attentions to the old woman.

I thought how absurd it was that doctors and nurses were going through the charade of treating the old woman as if she had a curable illness, when the truth - the 'elephant in the room' - was she was just very old and had probably reached the natural end of her life. But what was the alternative?

What upset me most of all was that the old woman appeared to be alone in the world. I thought of all the elderly people my mother knows who book unnecessary chiropody appointments, just so they can be touched by another person.

After a pain relief drip failed to make any difference, morphine was introduced. That didn't work either, but after three further doses, I noticed that although I could still feel the pain, I felt curiously detached from it.

I listened to the voices in the distance. Someone was being aggressive, but it was clear that they were very frightened. Another person kept talking in affected genteel accent about their 'anterior', trying to add a certain gravitas to their account, but undermining it with malapropisms.

As I listened to what was going on around me, what impressed me most was the utter professionalism of the staff, who appeared to treat every patient with an unfailing courtesy and respect. I had plenty of opportunities to eavesdrop on conversations and was impressed by what I heard. Lame jokes were laughed at, dull anecdotes listened to with interest and confusion met with patience.

I was less impressed by the patients, who were a rather rum bunch. A woman on my ward was booked in for an operation, but because she was obsese, diabetic and smoked 20 a day, the doctors wanted to run some tests on her heart first. Instead of being grateful for these precationary meaures, she whinged and moaned incessantly: "I wanna go 'ome today. I don't wanna hang around in this shithole."

I didn't like the woman's sense of entitlement, particularly given that her health problems appeared to be largely self-inflicted, but a universal healthcare system is there for the feckless, the irresponsible and the gluttonous as well as the abstainers, the joggers and the vegans.

An elderly man with the strongest Sussex accent I've ever heard complained about the meals at every opportunity: "Oi've got no complaint 'bout the 'awspital, but the food 'ere is doiabolical!" A Filipino nurse replied "If you don't like the food, I can get form for you to complain if you like." The Sussex man snorted: "Forrrm? Caahn't see that it would make any difference, moi dearr. S'no point tryin'. Nawbody listens."

Admittedly the food wasn't haute cuisine and it was appropriate that it was usually served by Eastern Europeans, as the last time I'd tasted anything like it was in communist Czechoslovakia, but it was still vaguely edible. As for the wards, they were anything but a 'shithole' - spotlessly clean and comfortable.

Perhaps I have lower standards.

My only complaints about the hospital were its design - which resembled one of those mazes that scientists use to induce stress in rats - and a litigation-avoiding obsession with doing everything in triplicate. When someone pressed down hard on my appendix, I consoled myself with the thought that now the diagnosis was complete, I'd never have to experience that pain again. How wrong I was.

But I had music with me, which helped more than anything else. If you're ever waiting to go into surgery, I can strongly recommend Mozart's sublime 'Soave sia il vento'.

After the operation, which wasn't the keyhole surgery I was hoping for, I spent the night in a dementia ward (the only place with an available bed) listening to one man yell "Ben!" every ten seconds for most of the night, while another shouted "Push down hard on the fog 'orns boys" (I don't think the sea view helped).

In the morning, I saw the full horror of dementia - a condition that I had only understood in an abstract way before. The person calling out for Ben turned out to be an Irishman named Bill, who had reached a state where he couldn't remember what a cup of tea was for and regularly tipped the contents all over his bed as he examined the cup, trying to guess its purpose.

Under the influence of morphine, the sound of Bill calling for Ben brought back the theme tune of a children's 'Watch with Mother' programme. But sadly the introduction of opiates into my system didn't result in any epic poems or symphonies.

People compare the very old to young children, but infants learn and remember. Bill was unlearning, becoming less competent with each day. Here was a man who once made people laugh, had a job and made love, reduced to a state where he could no longer recognise everyday objects or remember where he was for longer than two minutes.

Caring for Bill was draining. When he wasn't shouting for Ben, he yelled "Nurse!"every five or ten minutes and required a constant change of sheets. In the coming decades, the National Health Service will have to cater for a steadily increasing number of Bills. At what point will it become unsustainable?

But my experience during the last 48 hours emphasised the strengths of the NHS more than its weaknesses. The medical care was second to none and the wards were clean and comfortable. It made the current controversy in the US about Obamacare seem even more absurd.

This excellent cartoon has been doing the rounds recently (click on it to see the full cartoon). It lacks subtlety and the 'Anywhere but America' claim is inaccurate, but it still makes an important point:

Of course the NHS is far from perfect. People wait too long for important tests, operation waiting lists are often unacceptably long and the labyrinthine bureacracy can sometimes be hard to deal with, but overall, the sum is greater than its parts. It is a noble idea that, most of the time, actually works.

Long may it continue.